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When Breast Cancer Comes Back

Dec 28, 2015

Thanks to improvements in breast cancer treatment over the past several decades, the end of treatment for many women means their cancer is gone. A successful end to treatment can be both stressful and exciting. You’re likely to be relieved to finish treatment, but you may find it hard not to worry about cancer coming back. This is very common among people who have had cancer.

Steps for staying as healthy as possible include eating right, getting regular exercise, staying away from tobacco, limiting alcohol, and getting recommended screening tests. But sometimes, even when you’ve done everything within your power to lower your risk, you can still get cancer again.

When the same cancer comes back after treatment, whether it’s a short time later or many years later, it’s called recurrence. Recurrence can be local (in the same breast or in the mastectomy scar), regional (in nearby lymph nodes), or in a distant area. Cancer that is found in the other breast is not a recurrence—it is a new cancer that requires its own treatment.

Local recurrence

If your breast cancer has recurred locally, treatment depends on your first treatment. If you had breast-conserving surgery, a local recurrence in the breast is usually treated with mastectomy. If the first treatment was mastectomy, recurrence near the mastectomy site is treated by removing the tumor whenever possible. This is followed by radiation therapy, but only if you did not have radiation after your original surgery. (Radiation usually can’t be given to the same area twice.) Hormone therapy, targeted therapy, chemotherapy, or some combination of these may be used after surgery and/or radiation therapy.

Regional recurrence

When breast cancer comes back in nearby lymph nodes (such as those under the arm or around the collar bone), it is treated by removing those lymph nodes. This may be followed by radiation aimed at the area. Systemic treatment (such as chemotherapy, targeted therapy, or hormone therapy) may be considered after the local treatment as well.

Distant recurrence

In general, if your breast cancer comes back in other organs, such as the bones, lungs, or brain, you’ll be treated the same way as women who were originally diagnosed with stage IV breast cancer in these organs. Systemic treatment (such as chemo, targeted therapy, or hormone therapy) is usually the main treatment. It will depend on previous treatments you have had and the specifics of your breast cancer.

Recurrent breast cancer can sometimes be hard to treat. If you are in otherwise good health, you may want to think about taking part in a clinical trial testing a newer promising treatment.

Second cancers

Most women who’ve had breast cancer don’t get cancer again. But it does happen, especially because breast cancer survivors are at higher risk for getting another breast cancer, as well as some other types of cancer. This can be due to a number of factors, such as:

A woman’s genes, some of which might increase her risk for both breast and certain other cancers

Having other factors that increase her risk of both breast and other cancers

Stay on track with follow-up appointments after breast cancer treatment. These appointments are designed to look for any signs that the cancer has come back or spread, in order to catch it as early as possible.